Proposed Legislation Would Speed Up Appeal Process For Medicare Claims

Senate Finance Committee leaders have recently introduced bipartisan legislation that would create more funding and resources for the Medicare claims appeal process. “The Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 was formally introduced to the full Senate on Tuesday by Finance Committee Chairman Orrin Hatch (R-UT) and ranking member Ron Wyden (D-OR).” The proposed legislation will provide $125 million in funding to the Office of Medicare Hearing and Appeals. It will also provide $2 million of additional funding for the Department Appeals Board of the Department of Health and Human Services. There will also be a Medicare magistrate program that will be established to review claims appeals between $150 and $1,500. Administrative law judges will handle appeals that are over $1,500. The goal of this legislation is to cut down on the large backlog of Medicare appeals claims.

See Emily Mongan, Bill would speed up Medicare claims appeals process, McKnight’s, December 10, 2015.